Antibiotic Consumption and Its Relationship with Bacterial Resistance Profiles in ESKAPE Pathogens in a Peruvian Hospital

Pérez-Lazo, Giancarlo; Abarca-Salazar, Susan; Lovón, Renata; Rojas, Rafael Moreno; Ballena-López, José Carlos; Morales-Moreno, Adriana; Flores-Paredes, Wilfredo; Arenas-Ramírez, Berenice; Illescas, Luis Ricardo

doi:10.3390/antibiotics10101221

Cited by 11 publications

(23 citation statements)

References 35 publications

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“…had strains classified as pathogens of the ESKAPE group ( Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa, and Enterobacter species) 38 . These strains are well known in clinical settings and have the ability to resist the bactericidal or bacteriostatic actions of many antimicrobial agents by developing resistance mechanisms either by gene or plasmid acquisition or by genetic mutations 39 , 40 . The World Health Organization (WHO) listed these ESKAPE pathogens as being part of the most critical group of bacteria that represent a particular hazard in healthcare facilities like hospitals and nursing homes, where they can lead to serious and frequently fatal diseases like pneumonia and bloodstream infections 41 .…”

Section: Discussionmentioning

confidence: 99%

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Gnimatin

Weyori²,

Agossou

et al. 2022

Sci Rep

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Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43–2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28–2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.

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Section: Discussionmentioning

confidence: 99%

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Gnimatin

Weyori²,

Agossou

et al. 2022

Sci Rep

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“…The majority of the articles 13 (22.3%) were published in China [ 21 , 25 – 28 , 42 , 60 , 62 – 64 , 68 , 72 , 77 ], 4 (6.9%) Europe [ 48 , 49 , 74 , 75 ], 4 (6.9%) South Korea [ 31 , 54 , 61 , 65 ], 4 (6.9%) Serbia [ 34 , 36 , 39 , 52 ], 3 (5.2%) Japan [ 20 , 30 , 40 ], 2 (3.4%) Italy [ 22 , 33 ], 2 (3.4%) Thailand [ 35 , 57 ], 2 (3.4%) France [ 46 , 56 ], 2 (3.4%) Spain [ 43 , 59 ], 2 (3.4%) Slovenia [ 47 , 71 ], 2 (3.4%) Switzerland [ 45 , 70 ], and the rest were in different countries [ 23 , 29 , 32 , 37 , 38 , 41 , 44 , 50 , 51 , 53 , 55 , 58 , 66 , 67 , 69 , 73 , 76 , 77 ]. The majority of the articles 11(23.4%) were published in 2017 [ 22 , 33 , 36 , 44 , 47 , 48 , 52 , 56 , 59 , 64 , 67 ], 2018 […”

Section: Resultsmentioning

confidence: 99%

“…The unit of measure for ABC was not uniform for all articles. The units of ABC were standardized to 1000 patient days (DPDs) [ 21 – 23 , 25 , 30 , 31 , 35 , 37 , 40 , 41 , 44 , 46 , 49 – 52 , 55 – 61 , 64 – 68 , 77 ] and 100 patient days (DPDs) [ 20 , 26 – 29 , 32 – 34 , 36 , 38 , 39 , 42 , 43 , 45 , 53 , 69 , 70 , 73 , 76 ], but in addition, DIDs [ 30 , 40 , 47 , 48 , 56 , 59 , 65 , 66 , 68 , 71 , 72 , 74 , 75 ], grams [ 24 ], and average/percentage trend [ 54 , 62 ] were used to measure ABC. Accordingly, about 948017.9 DPDs (904622.9 standardized per 1000 patient days and 4339.5 per 100 patient days) and 4108.6 DIDs were reported, but about 173616.9 and 99800 were reported in average consumption and in grams, respectively.…”

Section: Resultsmentioning

confidence: 99%

Relationship between Antibiotic Consumption and Resistance: A Systematic Review

Abejew,

Wubetu,

Fenta

2024

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Unreserved use of antibiotics exerted selective pressure on susceptible bacteria, resulting in the survival of resistant strains. Despite this, the relationship between antibiotic resistance (ABR) and antibiotic consumption (ABC) is rarely studied. This systematic review aims to review the relationship between ABC and ABR from 2016 to 2022. Methods. Articles published over 7 years (2016–2022) were searched from December 23 to 31, 2022. The search strategy was developed by using keywords for ABC and ABR. From 3367 articles, 58 eligible articles were included in the final review. Results. The pooled ABC was 948017.9 DPDs and 4108.6 DIDs where over 70% of antibiotics were from the Watch and Reserve category based on the WHO AWaRe classification. The average pooled prevalence of ABR was 38.4%. Enterococcus faecium (59.4%), A. baumannii (52.6%), and P. aeruginosa (48.6%) were the most common antibiotic-resistant bacteria. Cephalosporins (76.8%), penicillin (58.3%), and aminoglycosides (52%) were commonly involved antibiotics in ABR. The positive correlation between ABR and consumption accounted for 311 (81%). The correlation between ABR P. aeruginosa and ABC accounted for 87 (22.7%), followed by 78 (20.3%) and 77 (20.1%) for ABR E. coli and K. pneumoniae with ABCs, respectively. Consumption of carbapenems and fluoroquinolones was most commonly correlated with resistance rates of P. aeruginosa, K. pneumoniae, E. coli, and A. baumannii. Conclusion. There is a positive correlation between ABC and the rate of ABR. The review also revealed a cross-resistance between the consumption of different antibiotics and ABR. Optimizing antibiotic therapy and reducing unnecessary ABC will prevent the emergence and spread of ABR. Thus, advocating the implementation of stewardship programs plays a pivotal role in containing ABR.

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“…This could be a trend associated with the effect of the ASP intervention. Medium-term objectives such as changes in the resistance profile of some germs such as Pseudomonas aeruginosa were documented in other areas of our center (ICU) in 2018 [ 42 ]. In light of the emergence of multidrug-resistant Enterobacteriaceae and evolving resistance patterns of Pseudomonas aeruginosa observed in our hospital, there is a need to explore non-carbapenem options for treating this group of pathogens.…”

Section: Discussionmentioning

confidence: 99%

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

et al. 2023

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The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (32 control, 30 group 1, 31 group 2). The median time to effective therapy was significantly shorter in group 2 compared to group 1 and control group, respectively (3.75 vs. 10 h, p = 0.004; 3.75 vs. 19 h, p < 0.001). No significant differences in terms of relapse of bacteremia, in-hospital mortality (all cause), and 30-day-all-cause hospital readmission between the three study periods were found. The appropriateness of empirical antimicrobial use, adding or change, and the following de-escalation or discontinuation was significant when the two intervention periods were compared with the control group (p < 0.001). In addition to the lack of local studies documenting the microbiological profile of FN episodes, adding syndromic panels-based testing could allow for the consolidation of ASP strategies.

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Antibiotic Consumption and Its Relationship with Bacterial Resistance Profiles in ESKAPE Pathogens in a Peruvian Hospital

Cited by 11 publications

References 35 publications

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Relationship between Antibiotic Consumption and Resistance: A Systematic Review

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

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